Obamacare: On the ropes?

The second open enrollment period for the Affordable Care Act began on November 15, but it seems like Obamacare has been under attack forever. Republican lawsuits make their way through the courts, Democratic candidates run from President Obama's signature achievement, and Democratic Senators openly question it.  Here are 10 things to know about the current state of the Patient Protection and Affordable Care Act and the threats facing it.

1. As of April 2014 (after the first open enrollment period), approximately 15.2 million previously uninsured had gained health care insurance as a result of the ACA - either through the Marketplace or through the Medicaid and CHIP expansions. Daily Kos notes that a) the uninsured rate dropped more than 30 percent from September 2013 to September 2014; b) healthcare spending in the U.S. grew at a slower rate in 2013 than it had in 53 years; c) an estimated 50,000 lives were saved between 2010 (when ACA was passed) and 2013 because hospitals have been made safer.

2. The original ACA provided for an expansion of state Medicaid systems that would have made health care affordable for an additional 21.3 million Americans by 2022. The Supreme Court made that provision voluntary and, as of October 2014, 23 states had chosen not to expand Medicaid coverage. Nearly 4 million poor uninsured adults fell into the“coverage gap” that resulted from state decisions not to expand Medicaid, meaning their income is above current Medicaid eligibility but below the lower limit for Marketplace premium tax credits.  With Republican victories at the state level in the midterms, this denial of affordable medical care will continue.

3. SCOTUS will hear King vs. Burwell this term. This case, as well as its related brethren (Halbig vs. Burwell, Pruitt vs. Burwell, and Indiana vs. IRS), would deny subsidies to people who obtained their healthcare plan through the Federal exchange rather than through a state exchange. If successful, as many as 13 million people in 37 states could be affected, For many of these, healthcare would once again become unaffordable.

4. King vs. Burwell rests on what Think Progress calls a "glorified typo." If read in isolation, one line of the Affordable Care Act suggests that only “an Exchange established by the State” can offer subsidies to help people pay for health insurance in the exchange. Previous Supreme Court decisions have noted that “a reviewing court should not confine itself to examining a particular statutory provision in isolation” as the “meaning—or ambiguity—of certain words or phrases may only become evident when placed in context.”

5.  With today's politicized Supreme Court, the outcome of King vs. Burwell will depend on Chief Justice Roberts. Once before, Roberts bucked conservative pressure when he sided with the court's liberals in determining the ACA to be constitutional. Will Roberts' concern for his legacy (or perhaps his conscience) let him do the right thing for the American people or will he cave to this political stunt and ignore previous Supreme Court rulings on the importance of context?

6.  Sen. Charles Schumer blamed the loss of the Senate and the general thumping of Democrats in the midterms on the timing of Obamare.  Perhaps the best response to Schumer came from Michael Hiltzik at the Los Angeles Times: "It's a startling admission of political spinelessness. Schumer gets the positive impact of the legislation wrong, he gets the politics of it wrong, and he displays a shocking ignorance of the problems facing the American middle class. The only good thing about his remarks is that they confirm how bad today's Democrats are at messaging."

7. The House GOP filed suit against President Obama on November 21. The lawsuit focuses on two points: (1) the administration's decision to delay the law's mandate that businesses with 50 or more workers provide comprehensive health benefits and (2) the requirement that insurers reduce the out-of-pocket expenses for lower-income customers with the government making "periodic and timely payments" to insurers to cover their costs. This suit is even more blatantly political than King vs. Burwell and stands less of a chance of success.  Still, as the LA Times opines in a November 24 editorial: "...it's worth noting how Republicans have sought to undermine and destabilize the Affordable Care Act by attacking the benefits it provides to Americans on the lowest economic rungs."

8. Retiring Sen. Tom Harkin, co-author of the ACA, now says that Democrats should have passed single payer healthcare when they had the chance in 2009.  By trying to address the concerns of three centrist Senators (Democrats Lincoln and Nelson and Independent Lieberman), the country ended up with a more complicated healthcare system. I agree with Sen. Harkin.  Single payer or public option healthcare would have been a better choice. Compromising did no good. The ACA passed the Senate without a single Republican vote and the complexity of the system has opened it to, as we have seen, unending lawsuits.

9. A GOP Senate can be counted on to try to dismantle the ACA in stages should both King vs. Burwell and the House GOP suit against Obama fail. The idea would be to gather enough Democratic votes to avoid a filibuster, or better, to override a Presidential veto. Based on discussions with health care experts and lobbyists, the New Republic lists these possible Republican actions:

(a) Repeal the individual mandate

(b) Repeal or modify the employer mandate

(c) Eliminate "risk corridors" (government reimbursement to insurers for some losses)

(d) Repeal the 2.3 percent medical device tax. Its primary purpose is to generate revenue to help subsidize healthcare costs for lower income people.

(e) Abolish the Individual Payment Advisory Board. IPAB is a board with the power to ratchet down what Medicare pays for goods and services.

(f) Introduce "copper plans" which would cover less (50%) of an individual's health care expenses than the current plan levels.

10. I'll close with commentary from a source I don't often cite. Forbes magazine, the self-proclaimed "capitalist tool," has some bad news for Obamacare bashers. A McKinsey Center report found that a) competition and choice are increasing among insurance companies; b) the median increase in premiums for 2015 will be 4% (Forbes' comment: "When was the last time we saw insurance premiums experience an annual increase of less than 5 percent? I cannot remember such a time and doubt that you can either."); c) premiums for those being subsidized will vary - with some likely to pay more and others likely to pay considerably less.  The author's closing advice is priceless: "Even if you are committed to bashing the ACA at all costs, do yourself a favor and go check out the policies available to you come November 15th. You are likely to find something to your liking at either a lower price or at a very small increase. Should you find such a policy, buy it and be secure in the knowledge that the next time you trash Obamacare nobody will have to know that you benefited personally from the program."

  

Sunday Roundup - December 7, 2014

This is the weekly selection of news and opinion from sources outside the US mainstream corporate media.  Today we look at Eric Garner's death, US deportations, Israeli politics, Senator Harkin on Obamacare, Ukraine, and in brief, South Sudan and Gaza.

Correction to December 3 post, "The Death of Michael Brown": The original post gave the distance from the shooter, Darren Wilson, to Michael Brown as 148 feet as estimated by an independent source.  148 feet was the distance from Darren Wilson's SUV to the point where Michael Brown had run as estimated by the independent source.

Eric Garner

Midtown New York, Dec. 5, Credit: REUTERS/Adrees Latif

A grand jury once again failed to indict after the death of an unarmed African-American at the hands of a white police officer.  The victim this time was Eric Garner and the place was New York City.  The case of New York Police Department officer David Pantaleo wasn’t supposed to be like Ferguson. There was a video showing how a simple stop for selling untaxed cigarettes turned into a chokehold — a move prohibited by the NYPD. The medical examiner ruled the incident a homicide. Eric Garner repeatedly shouted “I can’t breathe” just before he died.  Yet, as in Ferguson, the Staten Island grand jury voted not to indict Pantaleo for anything, leaving the nation — even legal experts – exasperated, frustrated, and grasping to understand why. [Think Progress, Dec. 3]  The White House announced a civil rights investigation as protesters took to the streets.  The US attorney general, Eric Holder, has announced a federal investigation into “potential civil rights violations” around the death of Eric Garner after a grand jury decided not to indict Daniel Pantaleo, the New York police officer who placed the unarmed black man in a chokehold.  Thousands of demonstrators disrupted New York City traffic into the early hours of Thursday after the grand jury verdict. Mostly peaceful protests had sprung up on Wednesday evening at locations throughout Manhattan, including Grand Central Terminal, Times Square and near Rockefeller Center, after the panel returned no indictment. [The Guardian, Dec. 4]  Protests in New York have continued into the weekend.  Protests over U.S. police violence against minorities, sparked by grand-jury decisions not to charge officers in two high-profile cases, were peaceful on their third night in New York although 20 arrests took place, authorities said on Saturday.  Protesters were arrested for disorderly conduct and blocking traffic on the city's FDR Drive, a major artery that runs along the eastern side of Manhattan....The wave of angry protests began on Wednesday when a New York grand jury declined to bring charges against white officer Daniel Pantaleo in the chokehold death of Eric Garner, a black 43-year-old father of six. [Reuters, Dec. 6]

Related
‘I can’t breathe’: Why Eric Garner protests are gaining momentum [Reuters, Dec. 5]  “Black Lives Matter” has become, like an earlier generation’s use of the terms “Freedom Now” and “We Shall Overcome,” an anthem for contemporary civil and human rights activism. The struggle for black equality historically and now, offers us all a chance to transform and save American democracy.

US Deportations
The American Civil Liberties Union released a report on Dec. 4 that underscores a troublesome pattern that has received far less attention [than Obama's immigration plan]: Of the 438,421 people deported in 2013, 83 percent received a summary removal, meaning that they were sent to their country of origin by US officials without a hearing. And according to the ACLU's research, many of these removals were illegal: Asylum seekers, unaccompanied kids, and others who may have qualified for relief routinely have been turned away.  There has been a backlog in the immigration court for many years and the deportations are being made using a 1996 law that, in theory, prevents immigration courts from being completely inundated while also providing safeguards...But according to the ACLU's findings, these protocols aren't often followed...No one, the ACLU included, seems to be able to provide a realistic solution to the immigration court backlog; it's undeniable that if all those requesting asylum were given a trial, the system would be further clogged.  [Mother Jones, Dec.4]

Israel
Benjamin Netanyahu's government collapsed after the ouster of two cabinet ministers who opposed the so-called "Jewish state" bill.  Three days after the Peace Now demonstration outside the Prime Minister’s home in Jerusalem, which featured a call for toppling and replacing Benjamin Netanyahu’s government, the government did in fact collapse. The Knesset is in the process of dissolving itself and its members have already agreed on a date for early elections.  Israelis will go to the polls on March 17, almost two full years before the end of the term of this government. [Americans for Peace Now, Dec. 3]  I'd like to share APN's optimism that the elections will bring to power an Israeli government committed to a two-state solution, but Israeli politics and public opinion continue to move to the right.  A new poll published Sunday in the Haaretz newspaper showed that while Netanyahu’s popularity is currently down, Israelis continue to support him over other prime ministerial candidates. Asked which politician is most suited to be prime minister, 35% answered Netanyahu....The same poll showed shrinking support for Lapid’s [the fired  finance minister's] centrist party and for the centrist-left-wing parties Hatnuah and Labor. The only parties to show gains are the right-wing Jewish Home and Israel Beiteinu Parties. [BuzzFeed, Dec. 3]
The UN overwhelmingly passed a non-binding resolution urging Israel to renounce possession of nuclear weapons and put its nuclear facilities under UN supervision and criticizing the country for not being part of the Nuclear Non-Proliferation Treaty.  Israel possesses an estimated 80 nuclear weapons.  The resolution calls on Israel to "accede to that treaty without further delay, not to develop, produce, test or otherwise acquire nuclear weapons, to renounce possession of nuclear weapons," and put its nuclear facilities under the safeguard of the UN's International Atomic Energy Agency...Israel, which is believed to have nuclear arms but has never admitted to it, has long been under fire from Arab countries in the region for not putting its alleged stockpile under international supervision.  The resolution, initiated by Egypt, was approved by 161 nations with only five voting against it and 18 abstentions.  [Russia Times, Dec. 3]

Senator Harkin:  We Should Have Passed Single-Payer
The coauthor of the Patient Protection and Affordable Care Act regrets that the filibuster-proof Senate of 2009 did not pass a single payer healthcare system instead.  Sen. Tom Harkin, one of the co-authors of the Affordable Care Act, now thinks Democrats may have been better off not passing it at all and holding out for a better bill.  The Iowa Democrat who chairs the Senate Health, Education, Labor and Pensions Committee, laments the complexity of legislation the Senate passed five years ago.  He wonders in hindsight whether the law was made overly complicated to satisfy the political concerns of a few Democratic centrists who have since left Congress....Harkin, who is retiring at the end of this Congress, says in retrospect the Democratic-controlled Senate and House should have enacted a single-payer healthcare system or a public option to give the uninsured access to government-run health plans that compete with private insurance companies.  “We had the votes in ’09. We had a huge majority in the House, we had 60 votes in the Senate,” he said.  He believes Congress should have enacted “single-payer right from the get-go or at least put a public option would have simplified a lot....  We had the votes to do that and we blew it,” he said....Harkin...believes Obama and Democratic leaders could have enacted better policy had they stood up to three centrists who balked at the public option: Sens. Joe Lieberman (Conn.), a Democrat turned independent, Blanche Lincoln (D-Ark.) and Ben Nelson (D-Neb.). [The Hill, Dec. 3]  

Ukraine
In spite of recent fighting near the Donetsk airport, there is hope for the shaky ceasefire in eastern Ukraine.  Ukraine and the pro-Russian rebels said Thursday they had agreed to halt fire on December 9 under the terms of a truce aimed at ending one of Europe's bloodiest conflicts in decades.  The unexpected announcement provides the latest glimmer of hope that fighting across the eastern rustbelt of the ex-Soviet nation was nearing to a close after eight months that saw 4,300 people killed and shattered Moscow's ties with the West....A source in [Ukrainian President] Poroshenko's office said the president's statement meant Ukraine would begin withdrawing heavy weapons from the eastern frontline on December 10 -- as long as the separatists also observed the truce....Several truce deals announced in the course of the war were broken within days by both rebels and Ukrainian soldiers who refused to listen to their political leaders. The head of the neighbouring self-proclaimed Lugansk People's Republic said a ceasefire that would begin in mid-December was discussed at the [September] Minsk negotiations. [AFP/ via Yahoo News, Dec. 4]

Related
"How can the West solve its Ukraine problem?" [BBC News, Dec. 3] Russia badly overplayed its hand last year ...The European Union is now risking the same thing by trying to bring Ukraine into the West without reference to economic reality or the willingness of European publics to bear the enormous costs involved.  The author lays out the economic and political reality in the Ukraine and the compromises needed by both sides for a lasting peace.

In Brief
South Sudan
The civil war in South Sudan claimed at least 50 000 lives so far [enca.com, Nov. 15]

"South Sudan: the impact of war and the importance of peace"  [The Guardian, Nov. 26] 
While South Sudan peace talks continue in Ethiopia and Tanzania, bitterly divided communities look for solutions closer to home.  The civil war in South Sudan has so far claimed at least 50,000 lives.

Gaza
U.N. begins inquiry into attacks and weapons in Gaza [Reuters, Dec. 3]

Project launched to clear Gaza rubble: UN begins clearing some 2.5 million tons of rubble from Strip, courtesy of $3.2 million donation from Sweden. [YNet/AP, Dec. 3]

Palestinian engineer has developed a replacement for cement to help the Gaza Strip deal with its housing crisis after the Israeli war [World Bulletin, Dec. 5] 
Since the July-August war, in which more than 2,100 Palestinians and 70 Israelis were killed, barely any progress has been made rebuilding the shattered territory, despite donors pledging $5 billion.  Israel tightly monitors the import of construction materials and equipment into Gaza, arguing that otherwise it could be used to rebuild tunnels used by Hamas who control the strip.  Palestinian officials and critics of Israeli policy say that has made it impossible to rebuild, leaving 40,000 of the strip's 1.8 million residents in temporary shelter and thousands more facing winter in barely habitable ruins. 

Updates and Briefs

"It's About Humanity. Pray for Gaza."
- Selena Gomez' Instagram

Gaza
The Palestinian death toll from the Israeli attacks now exceeds 650.  An estimated two-thirds of the Palestinian dead, more than 400, are civilians.  The civilian dead include at least 147 children and 74 women.  The Israeli civilian death toll stands at 2.  In an article published today, The Irish Times reported on the UN High Commissioner for Human Rights statement that "that Israel may be committing war crimes in Gaza, where its punitive house demolitions and killing of children raise the 'strong possibility' that it is violating international law."  The comments came at an emergency debate at the UN Human Rights Council in Geneva.  Ms. Pillay also condemned the indiscriminate firing of rockets and mortars by Hamas into Israel.  The Irish Times reported on John Kerry's diplomatic efforts: "In a sign of the intensity of the US diplomacy, Mr Kerry spoke to Qatari and Turkish foreign ministers after meeting [Egyptian President] Sisi for two hours, a senior US official said."  So far there is no sign of a letup in the fighting.  The article quotes a 17 year old Palestinian on the desperation of the Gazans fleeing their homes in the face of the Israeli onslaught: “Columns of people are heading west of Beit Hanoun, looking for a safe shelter. This is not war, this is annihilation."

In a companion article, Ambassador Patricia O'Brien, Ireland's representative to the meeting of the Human Rights Council, is quoted: “Irish people have been appalled by the upsurge of violence in Gaza, and especially the very high and unacceptable level of civilian casualties.  It is clear to us that neither side is paying adequate regard to the cost of their actions on innocent civilians.”   Ms O’ Brien said no ceasefire would last without a serious political effort to 'address the causes of the disastrous situation in Gaza'...The continued absence for people in Gaza of any political or economic perspective for the future is a breeding ground for extremist action.”  Would that some US politicians had the courage and moral clarity of the 57 year old UN Ambassador O'Brien and the 21 year old entertainer Selena Gomez.

Obamacare Rulings
"Two federal appeals court panels issued conflicting rulings Tuesday on whether the government could subsidize health insurance premiums for [4.5 million] Americans...By a vote of 2 to 1, a panel of the United States Court of Appeals for the District of Columbia struck down a regulation issued by the Internal Revenue Service that authorizes the payment of premium subsidies in states that rely on the federal insurance exchange...Within hours, a unanimous three-judge panel of the United States Court of Appeals for the Fourth Circuit, in Richmond, Va., issued a ruling that came to the opposite conclusion."  [NYTimes, July 22] The rulings will not affect consumers immediately as the Obama Administration will continue to provide subsidies until the appeals process takes place.  Despite the Obama Administration's optimism that the D.C. panel will be overruled, this has the potential to reach the Supreme Court.  The Supreme Court has already weakened the Affordable Care Act considerably in its ruling that states were not required to expand Medicaid.  Just because Chief Justice Roberts voted once to uphold the law - so his court would not look like a total political shill - doesn't mean he will do it again.  Just a brief review of the rulings of this court will show that he's apparently no longer concerned about the court's credibility.

Constitutional Amendment to Overturn Citizens United and McCutcheon vs. FEC
One way to amend the constitution is for 2/3 of the states (34) to call for a Constitutional Convention to consider the amendment.  Two states (California and Vermont) have passed such resolutions to overturn the Supreme Court rulings that have removed campaign finance limits.  A third state, Illinois, is considering a similar resolution.  A total of 16 states have passed resolutions or ballot initiatives to overturn Citizens United.   The other way to amend the Constitution is for Congress, by a 2/3 vote, to send the amendment to the states for ratification.  The amendment is enacted once 3/4 of the states (38) approve it.  On July 10, in a straight party line vote, the Senate Judiciary Committee voted to approve an amendment that would restore to Congress and the States the power to regulate the financing of political campaigns.  The party line vote means that it is unlikely that the amendment will be referred to the states.  So, for now, it is up to individual states to call for a Constitutional Convention. [TPM, July 10]

Iran Completes Conversion of 20% Uranium
The BBC reported on July 20: "Iran has turned all of its enriched uranium closest to the level needed to make nuclear arms into more harmless forms, the UN nuclear agency says...A new report from the International Atomic Energy Agency (IAEA) says Iran is observing all of its other commitments as well."  This was a major diplomatic victory for Obama's Iran policy and nary a peep was heard in the US corporate media.

Record June Temperatures
"The combined average temperature over global land and ocean surfaces for June 2014 was the highest on record for the month, at 0.72°C (1.30°F) above the 20th century average of 15.5°C (59.9°F)." [NOAA, Global Analysis - June 2014]

Sunday Roundup - May 11

This is the weekly selection of news and opinion from sources outside the US mainstream corporate media. Today we look at Obamacare, Republicans' economic myths, Iran's nuclear program, Pope Francis' comments on inequality to UN officials, Obama's last chance on the environment, and Ukraine.

Obamacare
The first open enrollment period for the Affordable Care Act is complete and the numbers are in. Total enrollments came to at least 17.8 million, once you add together numbers from Medicaid [expansion], marketplace enrollments and the lowest estimates of how many people bought new ACA-compliant policies outside the exchanges. [NPR Shots blog, May 2]  That didn't stop Republicans from holding yet another hearing to convince people that the program is a failure.  House Republicans brought in insurance executives on Wednesday and tried to get them to say that only 2/3 of the enrollees had paid their premiums.  The executives were having  none of it.  As Salon.com reported: A slate of health insurance industry executives sat down in front of the House Energy and Commerce subcommittee for oversight and gave their estimates for how many people who signed up for health coverage through the Affordable Care Act actually paid their first month’s premium....Across the board, the health insurance executives testified that the payment rate for premiums was somewhere between 80 and 90 percent, while stressing that these data are preliminary and that outstanding payments are still coming in.  After this latest rebuke to their fact-free view of reality, Republicans are apparently now turning to Plan B - using the Benghazi tragedy as something to stir up their base and raise money.

Economic Myths
Health care is just one of the many issues where Republicans refuse to face reality.  Sean McElwee in an April 28 article in Rolling Stone enumerates the extensive studies that show just about everything the Republicans believe about the economy to be wrong.  After quoting economist John Maynard Keynes famous line "When the facts change, I change my mind. What do you do, sir?", McElwee writes: Sadly, in their quest to concentrate economic and political power in the hands of the wealthiest members of society, today's Republicans have held the opposite position – as the evidence has piled up against them, they continue spreading the same myths.  McElwee proceeds to demolish right-wing myths about the minimum wage, the stimulus, taxing the rich, global warming and the Affordable Care Act.  It's a great, quick read and a good antidote to the nonsense that will be spewing in ever greater quantities from Republican mouths and right-wing media as the election season approaches.

Iran's Nuclear Program
John Glaser relates the comments of the former head of Israel's Atomic Energy Commission in a May 8 post at antiwar.org: The former head of Israel’s Atomic Energy Commission believes Iran is more than a decade away from a nuclear weapon and that the Islamic Republic may not even want “the bomb,” according to the Israeli newspaper Yediot Ahronoth (Ynet news)....Brigadier General (res.) Uzi Eilam, who for a decade headed the Israel Atomic Energy Commission, does not believe that Tehran is even close to having a bomb, if that is even what it really aspires to.  Glaser points out that this is consistent with US intelligence estimates and that Eilam is not the first Israeli insider to counter the political rhetoric of the Israeli right and Prime Minister Netanyahu, who have opposed the Iran nuclear negotiations.  Glaser wonders why despite Iran’s cooperation and compliance in unprecedented negotiations with world powers that aim to partially retard and comprehensively limit their civilian nuclear program, Western commentators of all stripes continue to refer to Iran's "nuclear weapons program".


"Legitimate Redistribution of Wealth to the Poor"

The Pope and Un Secretary General Ban Ki-Moon
(Vatican Network website)

Pope Francis spoke to UN officials in Rome May 9, urging world leaders to resist the economy of exclusion and serve the poor.  As reported at the Common Dreams website: Pope Francis on Friday issued another indictment of inequality, saying that equitable economic and social progress are only possible through solidarity and generosity, and require the legitimate redistribution of wealth..."A contribution to this equitable development will also be made both by international activity aimed at the integral human development of all the world's peoples and by the legitimate redistribution of economic benefits by the State, as well as indispensable cooperation between the private sector and civil society," he continued.  HoundDog's May 9 blog at the DailyKos added:  Pope Francis' authentic Christianity comes as such an unfamiliar shock to many, that Pope Francis has had to deny he was a Marxist. He had a similar message to the World Economic Forum in January...Pope Francis' passion to improve the conditions of the world's poor, support for social justice inspires me....What will right-wing conservatives have to say about this? I can not wait to see how Representative Paul Ryan revises his draconian budget proposal which contains harsh cut backs in programs for the poor. Ryan has proclaimed his budgets are consistent with Catholic teachings, a claim I assert is simply impossible to support now.

Obama and the Environment
Calling it Obama's "last shot" to do something on the environment, Jeff Goodell wrote in an April 23 post in Rolling Stone magazine: In the next few months, [Obama] will take one of the biggest gambles of his presidency by testing the radical proposition that even SUV-loving Americans believe that global warming is real and are ready to do something about it....It's a gamble that could have a profound impact on energy politics, our economy and our ability to stabilize the climate. But if the president is wrong, it could not only cost his party control of the Senate this fall but also blow the last opportunity we have to save ourselves from life on a superheated planet.  Obama will take action in three key areas.

• In June, the EPA is expected to announce new rules for power plants, setting limits on carbon pollution.  Obama will be using his presidential powers to effectively hasten the phase-out of dirty coal from America's energy system. Right now, coal-fired power plants generate about 40 percent of the electricity in the U.S. and are by far the largest single source of heat-trapping gases.  
• A decision on the Keystone XL pipeline has been delayed while lawsuits on the pipeline's route go through the courts.  These are not expected to be resolved until after the November elections.  Goodell writes:  Although no final decision has been made, two high-level sources in the Obama administration told me recently that the president has all but decided to deny the permit for the pipeline.
• The next global climate summit will be in Paris in December 2015.  The objective is an international treaty to reduce carbon pollution.  Climate change, of course, is a global problem, and ultimately what matters is the degree to which Obama's actions in the U.S. inspire the world.  Regarding the international summit, Goodell quotes John Podesta, Obama's point man on climate policy: "Are we going to be on track to come to an agreement that will limit warming to 2 degrees Celsius, which is the threshold scientists have set for dangerous climate change?  Our goal is to give leadership and credibility to that effort."

Map is from infoplease.com

Ukraine

Ukraine is moving towards civil war as the government in Kiev cracks down on pro-separatists and as Donetsk, defying both Kiev and Putin, goes ahead with a referendum Sunday to create a quasi-independent statelet there.  [The Guardian, May 10]

Links
Complete text of Pope Francis' comments to UN

Obamacare Done Good!

The open enrollment deadline has passed and it looks like about 7 million people have enrolled through the healthcare exchanges set up by the Affordable Care Act.  There was a huge surge in the last days and, in spite of a couple of system shutdowns yesterday, Obamacare appears to have reached it's original (i.e., before the website problems of last October) goal of 7 million signups.

It's bound to be a major topic in the midterm elections.  Up to the end, Republicans have tried to deny the real good that it has done and, in November, they will run on a platform whose centerpiece is to repeal it.  They have nothing else to show for their most recent term.  Well I guess they can say "Hey, we only shutdown the government once!" 

It being April Fool's Day, I thought I'd present a few of the egregious and ridiculous comments recently emitted from the mouths of politicians and political commentators on the subject and then give some facts. 


With 7 million people signed up for Obamacare, Republicans are hard pressed to continue to call it a disastrous failure.   That doesn't stop them from continuing the assault against the Affordable Care Act.  On Sunday, "Sen. John Barrasso (R-Wyo.)...dismissed the White House's recent announcement that Obamacare enrollment had reached more than 6 million people, calling it a meaningless figure. 'I don't think it means anything. ... I think they're cooking the books on this,' said Barrasso on  Fox News Sunday."[Huffington Post, March 30]

Fox News “Medical A-Team” contributor Dr. Manny Alvarez, “explaining” the purpose of the Affordable Care Act: “We did it for nothing. We did it to confuse America. We did it to create a false tax. We did it to create an environment of punitive damages to people that don’t follow what the federal government tells them to do.”
Read more at http://www.newshounds.us/fox_news_outrageous_quote_of_the_week_poll_3_16_14_3_22_14_03242014#7E0Jh72SwkT5Uyq1.99

Fox News “Medical A-Team” contributor Dr. Manny Alvarez, “explaining” the purpose of the Affordable Care Act: “We did it for nothing. We did it to confuse America. We did it to create a false tax. We did it to create an environment of punitive damages to people that don’t follow what the federal government tells them to do.” [Newshounds website, March 24]

No discussion of Republican blathering would be complete without an entry from Michelle Bachmann.  Here's her take on the Administration decision to extend the deadline for people who started but did not complete their applications before midnight March 31.  "Unfortunately, it is the continuation of lawlessness from the administration,” Bachmann told Fox News’s Neil Cavuto on Wednesday. [Daily Kos, March 27]

I guess you notice a theme here.  These inane comments are all from commentary on Fox "News" shows.

Now for some facts.

In addition to the 7 million sign-ups, the ACA provided numerous improvements to health care insurance in our country- including provisions that

• Let young adults stay on their plan until 26
• Stop insurance companies from dropping you when you are sick or if you make an honest mistake on your application
• Prevent against gender discrimination
• Stop insurance companies from making unjustified rate hikes
• Do away with life-time and annual limits
• Give you the right to a rapid appeal of insurance company decisions
• Require all insurers to cover people with pre-existing conditions  
• Require that all non-grandfathered health insurance plans cover preventive services (including yearly check-ups, immunizations, counseling, and screenings) at no out-of-pocket costs 
• Essential health benefits (including emergency care, hospitalization, prescription drugs, maternity, and newborn care) must be included on all non-grandfathered plans with no annual or lifetime dollar limits.

For more information on the Affordable Care Act, see the Obamacare Facts website.

Conservative groups spent millions trying to dissuade people, especially young and healthy people,  from signing up.  The Republican-controlled House of Representatives voted 50 times to repeal it or change it.  Misleading Obamacare horror stories filled the airwaves.  States refused to help people understand the law.  For nearly a month at startup, the healthcare.gov site was basically non-functional.  Still 7 million people cut through the crap thrown at them and applied.  In addition to the health exchange signups, there are millions of working poor who will now qualify for Medicaid thanks to the Medicaid expansion provision of the law.

But still the work for health care coverage is not done.

The main driving force for the ACA was to provide health care coverage for those who could not afford it.  An important provision in achieving this was the Medicaid expansion.  The intent was to cover the gap between Medicaid recipients and those who could still not afford health care insurance even with a subsidy.  State expansion of Medicaid was made voluntary by the Supreme Court in its decision on the constitutionality of the Affordable Care Act.  This decision was a game-changer

Republican governors and state legislatures, for the most part, prevented Medicaid expansion from taking effect in their state.  They did this despite the fact that the Federal government would cover about 93% of the costs for the first nine years of the expansion (2014-2022).  The CBO estimated that if all states expanded Medicaid coverage under the provisions of the ACA, 17 million people would be eligible.  

With many red states refusing to expand Medicaid at this time, between 7 and 8 million people will still not be able to afford health insurance.  States can decide to expand Medicaid at a later date.  Let's hope they do so and that public pressuring such as MoveOn.org's billboard campaign will help bring this about.  For the cost to expansion-denying states will be more than lost Federal dollars.  It will be lives. 

If the Republicans bring up their "death panel" lies again, I suggest we direct them to the January 2014 Harvard Medical School researcher's study: "Opting Out Of Medicaid Expansion: The Health And Financial Impacts."  The study estimates from 7,000 to 17,000 needless deaths per year because of these state decision to keep the working poor uninsured. [Daily Kos, March 30]

So to those GOPer's who want to make Obamacare "the issue" in the mid-terms, I say "Bring it on!"

Food Stamps, Obamacare, The Ukraine

The Ukraine
Russia is wrong to send troops into the Ukraine.  Not anywhere on the scale of US wrong in invading Iraq, for example, but wrong nonetheless.  The Ukraine and Russia share more than 1400 miles of border and you can see how Russia may have concerns about stability on its door step.

(Map is adapted from ESL-in-Canada's website)

The situation in the Ukraine is complex but here's a brief summary.

• The elected president of the Ukraine, Viktor Yanukovich, was ousted after demonstrations protesting his cancellation of talks on a European Union trade agreement.  Russia had offered $15 billion in aid to keep the Ukraine in their sphere of influence.  Yanukovich's  sympathies and inclinations lie more with Russia than Europe.  
• Yanukovich's assets and those of 17 others were frozen this morning by the EU, alleging embezzlement of government funds.  
• The Crimean Parliament has voted to leave the Ukraine and join Russia with a referendum set for March 16.  Crimea has a large Russian population and was part of the Soviet Union until 1954, when Nikita Khruschev gave it to the Ukraine. 

The turmoil in the Ukraine is being identified as a restart of the Cold War.  This is utter nonsense.  An editorial in The Nation calls for "the international community [to push] for compromise to prevent this fragile and bitterly divided country from breaking apart."  The Nation notes "We are reaping the bitter fruit of a deeply flawed post–Cold War settlement that looks more like Versailles than Bretton Woods, a settlement inflamed by the shortsighted American decision to expand NATO eastward and pursue other policies aimed at isolating Russia and ignoring Russian interests."

Food Stamps
Democratic governors in New York and Connecticut and the Republican governor of Pennsylvania have taken measures to thwart the Congressional cuts to the Supplemental Nutrition Assistance Program.  As explained at philly.com : "The cuts to SNAP delineated in the federal Farm Bill passed last month were being borne by 15 states that operate the "Heat and Eat" program, which coordinates energy assistance with SNAP...Under the program, some of the families that received as little as $1 in federal heating assistance saw increased SNAP benefits...Last month, Congress changed the rules, stipulating in the Farm Bill that a family would have to have at least $20 in heating assistance before receiving increased SNAP benefits."  And that's exactly what these governors have done.  Kudos and let's get the governors of the rest of the states affected by these cuts (see below) to act in a similar manner.

Comedy Central's Jon Stewart has a hilarious take down of Fox News' whining about food stamp recipients.  You can watch it here.

Obamacare
As the well-funded Republican right continues to pour millions into negative ad's against swing state Democratic Senators supportive of the Affordable Care Act and as the do-nothing House of Representatives vote yet again to defund or subvert the program, "Obamacare" enrollments are quietly growing.  As of February 1, enrollments in the Obamacare market place were nearly 3.3 million.  Also, according to ThinkProgress, in what it calls the woodwork effect,: "A new analysis by Avalere Health finds that the Affordable Care Act’s open enrollment season is boosting Medicaid signups even in the states that have refused the health law’s optional Medicaid expansion...All told, between 2.4 million and 3.5 million of the poorest Americans started receiving Medicaid coverage for the first time during the first four months of Obamacare’s enrollment season."  So as of end January, there were an additional 6 million people with health insurance.

ACA proponents are not done yet.  MoveOn.org has mounted a campaign to get non-Medicaid-expansion states to change their decisions.  The advantages to the states seem to be coming more and more clear: "Faced with the prospect of tens of millions, if not hundreds of millions, in federal funding, states are racing to find politically palatable ways to expand Medicaid. [Washington Post, March 4].  Even the brilliant op-ed writers for self-proclaimed "capitalist tool" Forbes are changing their tune.  Take a look at these two headlines:
Nov. 11 - "Obamacare Will Be Repealed Well In Advance Of The 2014 Elections"
Feb. 12 - "New Signup Numbers Show Why Obamacare May Be Impossible To Repeal"

But don't expect the right-wing to throw in the towel.  They will continue to spend tens of millions in negative ads even though as Kevin Drum wonders "whether there's a single genuine Obamacare horror story out there, given that virtually every yarn promoted by Republicans or conservatives about people hurt by the Affordable Care Act has deflated like a pricked balloon on the merest examination." [LA Times, Feb 20]


In the final set of rules published Wednesday, the Obama administration will "let people with health insurance plans that don't comply with Affordable Care Act standards keep them through October 2017 if their states allow it."  [CNBC, March 5]

The enrollment deadline - after which an individual without health care insurance may be subject to a fine - is March 31.  If you haven't got insurance yet, here's a link to healthcare.gov to help you get started. The site works.

Other info
"Those “heat and eat” states are: California, Connecticut, Delaware, Maine, Massachusetts, Michigan, Montana, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, Wisconsin. Some lists compiled by non-profits lists add or subtract a state or two from that lineup." [Washington Post, Feb 5]

Finally, a couple of links from the Daily Kos website:

Minimum wage increase would cut food stamp costs beyond Republican's wildest dreams 
(based on a report by the Center for American Progress)

Obamacare boosting household income and  spending (based on an article that first appeared in the Wall Street Journal)

The cuts to SNAP delineated in the federal Farm Bill passed last month were being borne by 15 states that operate the "Heat and Eat" program, which coordinates energy assistance with SNAP. Both Pennsylvania and New Jersey are Heat and Eat states.
Under the program, some of the families that received as little as $1 in federal heating assistance saw increased SNAP benefits.
Last month, Congress changed the rules, stipulating in the Farm Bill that a family would have to have at least $20 in heating assistance before receiving increased SNAP benefits.

Read more at http://www.philly.com/philly/news/politics/20140306_In_surprising_move__Corbett_forestalls_deep_cuts_in_food_stamps.html#A2ZZrfpZ6fFPkBkp.99

The cuts to SNAP delineated in the federal Farm Bill passed last month were being borne by 15 states that operate the "Heat and Eat" program, which coordinates energy assistance with SNAP. Both Pennsylvania and New Jersey are Heat and Eat states.
Under the program, some of the families that received as little as $1 in federal heating assistance saw increased SNAP benefits.
Last month, Congress changed the rules, stipulating in the Farm Bill that a family would have to have at least $20 in heating assistance before receiving increased SNAP benefits.

Read more at http://www.philly.com/philly/news/politics/20140306_In_surprising_move__Corbett_forestalls_deep_cuts_in_food_stamps.html#A2ZZrfpZ6fFPkBkp.99

The cuts to SNAP delineated in the federal Farm Bill passed last month were being borne by 15 states that operate the "Heat and Eat" program, which coordinates energy assistance with SNAP. Both Pennsylvania and New Jersey are Heat and Eat states.
Under the program, some of the families that received as little as $1 in federal heating assistance saw increased SNAP benefits.
Last month, Congress changed the rules, stipulating in the Farm Bill that a family would have to have at least $20 in heating assistance before receiving increased SNAP benefits.

Read more at http://www.philly.com/philly/news/politics/20140306_In_surprising_move__Corbett_forestalls_deep_cuts_in_food_stamps.html#A2ZZrfpZ6fFPkBkp.99

Raise the Minimum Wage Now

Back from a brief vacation, in which I spent little to no time following the news, I see nothing much has changed.  One good thing that did happen is that the debt ceiling appears to have been suspended until March 2015.  That will at least make it a non-issue for the months leading up to the midterm elections. 


One item that will be an issue in the midterms is the minimum wage.   The positions on this are pretty much what you'd expect - Democrats support it and Republicans oppose it.  Muddying the waters right now is a CBO report that says raising the minimum wage to $10.10 would lift 900,000 workers out of poverty but potentially cause a loss of 500,000 jobs - though they admit the job loss could be very slight or up to a million.  Sounds like a compromise guess to me.  One guy says "Hey, we could lose a million jobs!".  Another says, "Not so, historically we've lost almost none whenever we've done this before."  "Okay let's say it's somewhere in the middle - 500,000."  "Agreed." 


Prone as CBO statements are to misinterpretation or outright abuse, this one will go far to aid the Republicans.  But what has been the historical impact on job growth and what do today's leading economists say?


Historically, there has been little impact of changes in minimum wage on employment rate.  A landmark 2010 study at the University of California- Berkeley examined the effects of the numerous state changes to minimum wage during the 1990's and 2000's.   By comparing counties that did raise the minimum wage with cross-state counties that did not, they found little to no impact on employment.


In fact, the effect of minimum wage changes on employment is one of the most studied in all of economics.  In 2013, the Center for Economic and Policy Research reviewed these studies and concluded: "The weight of that evidence points to little or no employment response to modest increases in the minimum wage."  CEPR then went on to examine "why the measured employment effects are so consistently small. The strongest evidence suggests that the most important channels of adjustment are: reductions in labor turnover; improvements in organizational efficiency; reductions in wages of higher earners ("wage compression"); and small price increases. Given the relatively small cost to employers of modest increases in the minimum wage, these adjustment mechanisms appear to be more than sufficient to avoid employment losses, even for employers with a large share of low-wage workers."


So when discussing this with your Fox News watching friends and relatives, here are a few more nuggets to toss their way from a fact check on MediaMatters.org that destroy the myth of job loss, the damage to small businesses or the preponderance of teenagers in minimum wage jobs:

• Numerous Studies Suggest Minimum Wage Increases Don't Kill Jobs, And May Even Increase Hiring
• Research Suggests Minimum Wage Increases Do Not Hurt Teen Employment
• Data Show States With Increased Minimum Wage Had Higher Small Business Job Growth. 
• "Indicators Of Economic Performance Were Consistently Better" In Higher Minimum Wage States For Small Business Job Growth
• Minimum Wage Growth Has Lagged Inflation, Leaving Minimum Wage Earners With Far Less Purchasing Power Today Than Previous Decades
• Half Of Minimum Wage Earners Are 25 Or Older, Representing Millions Of Adult Workers
• Less Than A Quarter Of Minimum Wage Earners Are Younger Than 20

The Raise the Minimum Wage. com website covers much of the same ground but also summarizes data from several other sources:

• leading economists agreed by a nearly 4 to 1 margin that the benefits of raising and indexing the minimum wage outweigh the costs.
• the most precise economic studies show no impact of minimum wage on job loss
• studies showing job loss from minimum wage increases invariably use imprecise or faulty methodology 

On the Misuse of CBO statements

A recent egregious example of the misuse of CBO statements occurred a week or so ago when Republicans started screaming "job loss from Obamacare."  What the CBO statement really said was that some may choose to work less hours or perhaps retire if they were given a chance to have affordable health care.  It's a demand side adjustment, you morons!  Not having to work two jobs to have health care is a good thing.  Not worrying about health care in retirement (whether forced or unforced) is a good thing.  These jobs will not go away - others will fill them and reduce the level of unemployment in the country.

Sunday Round-Up - January 26, 2014

This is the weekly selection of news and opinion from sources outside the US mainstream media.  Today we look at the Congressional threat to the Iran nuclear deal.  We also look at, in brief, the Geneva II peace talks, the Affordable Care Act's lost voter registration opportunity, the impending age of robots and Ferrari's new Formula 1 design.

Iran Nuclear Deal
In a January 21st Op-Ed at the Carnegie Endowment for International Peace website, CEIP President Jessica Tuchman Mathews writes that after a decade long impasse on Iran's nuclear program, world powers and Iran are on the verge of a solution.  "Yet the US Congress, acting reflexively against Iran, and under intense pressure from Israel, seems ready to shatter the agreement with a bill that takes no account of Iranian political developments, misunderstands proliferation realities, and ignores the dire national security consequences for the United States."  Mathews notes that the US's unilateral sanctions did nothing to stop Iran's uranium enrichment since the sanctions had little support in the international community.  Other world powers looked at the sanctions as an attempt to stop Iran from enriching nuclear fuel for peaceful purposes as was its right as a signatory to the Nuclear Non-Proliferation Treaty.  The situation changed in 2009 when President Obama stated that he was willing to engage in a serious dialogue to allay growing concerns over Iran's nuclear enrichment.  The sanctions gained  international community support and seriously impacted Iran's economy.  "No outsider can say for certain that Iran ever definitively chose to become a nuclear weapons state. On the one hand, it has spent billions of dollars pursuing activities that can be rationally explained only if the regime seeks the ability to produce weapons....Yet Tehran has also said that it does not want nuclear weapons. It has argued that nuclear weapons would not be appropriate for an effective military strategy and that they would violate the principles of the Islamic Republic."

One thing that is clear is that "Iran has been unambiguous in insisting on its right to uranium enrichment...Those like [Israeli] Prime Minister Benjamin Netanyahu who insist that the only acceptable level is zero enrichment in Iran know, or should know, that they are using code for 'no deal would be acceptable.' "  Attacks on Iran's nuclear enrichment facilities would delay but not stop its program and it would cause the international consensus on sanctions to collapse.  "Countries like Russia, China, Turkey, India, and Japan that have adopted the oil and financial sanctions against Iran with varying degrees of reluctance are unlikely to sustain them to support a war against enrichment"  Such illegitimate attacks would also strengthen the hand of Iranian hard-liners, make it impossible to have inspections, and, if Iran then chose to actually develop nuclear weapons, cause another round of proliferation in an already unstable region. 

As to the terms of the nuclear deal, "Iran agreed to eliminate its existing stockpile of 20 percent enriched uranium either by diluting it down to low enrichment or converting it to an oxide form that is not adaptable for further enrichment,...[to stop] the operation or the installation of additional advanced centrifuges,...halt progress on the [plutonium] reactor under construction at Arak", and limit its stock of low-enriched uranium.  Finally "To reduce the possibility that Iran could be running covert, hidden fuel cycles, it extends monitoring for the first time to uranium mines and mills and to centrifuge production and assembly facilities. These inspections are unprecedented in both frequency and extent."  In return Iran has $7 billion in sanctions lifted.

All this is now in jeopardy if the new Iran sanctions bill is approved by congress - the Senate is eight or nine votes shy of  a veto-proof bill.  "Its passage, as an act of bad faith on the US’s part after having just agreed not to impose new sanctions during the term of the six-month deal, would probably cause Iran to walk away from the negotiations." Mathews concludes: "A final agreement is by no means assured, but the opportunity is assuredly here. The price of an agreement will be accepting a thoroughly monitored, appropriately sized enrichment program in Iran that does not rise over 5 percent. The alternatives are war or a nuclear-armed Iran. Should this be a hard choice? Astonishingly, too many members of Congress seem to think so."
(Mathews article was originally published in The New York Review of Books.)

Let's hope that Harry Reid can keep the bill from reaching the Senate floor and that no other Senators  sign on to this ill-thought-out and dangerous piece of legislation.

In Brief (Links)
[Mother Jones, January 23] Is the HHS running from a voter registration fight with Republicans?  The health insurance exchanges set up under Obamacare, as agencies providing public assistance, are required by federal law to help millions of uninsured Americans register to vote. But the Obama administration is refusing to fully comply with that law.

[La Repubblica. January 24]   "F14-T will be the new Maranello red."  The new Formula 1 race car from Ferrari will try to win the 2014 F1 World Cup.  The car was named after an online vote of Ferrari fans worldwide.  [Official photos]

 

[Mother Jones, January 23] Unlimited incomes in a world run by artificial intelligences?  These speculative ideas appear in a working paper by, believe it or not, the San Francisco Federal Reserve Bank.  Kevin Drum, commenting on a James Pethokoukis post, writes that the general idea that robots and AI are...going to have a huge economic impact in the medium term future...is something that seems so obvious to me that I'm a little puzzled that there's anyone left who still doesn't see it."  [Pethokoukis' post is even more mind-boggling in its discussion of the AI singularity.]

With 130,000 dead and 9.5 million displaced, the Syrian Civil War is approaching the end of its third year.  Amidst low expectations, the Geneva II Conference got underway this past Wednesday.  The first face-to-face meetings between the opposing parties were held Saturday with only UN mediator Lakhdar Brahimi speaking and no agreements made.  [The Guardian, January 25] Al Jazeera has a number of articles and opinion pieces about the conference: Randa Slim in a January 23 op-ed notes that first peace initiatives rarely produce agreements to end conflict and Syria is not likely to be an exception.  She points to two successful conferences as models - the "Dayton accords which in the 1990s brought an end to the civil war in Bosnia...and the Bonn 2001 Conference in which the international community enabled an interim government to come to power in Afghanistan after the collapse of the Taliban regime."  Rami Khouri explains in another op-ed post why Iran's presence in Geneva II is critical for any progress.

State Of Obamacare

I've been fortunate . I've been covered by health insurance since the day I was born. To me it seems natural and more necessary than almost any other type of insurance. Why anyone would want to deny this to their fellows is beyond my comprehension. Health care is a right, not a privilege. And don't say that we, the richest nation on the planet, can't afford it. With some adjustments to the military budget and the tax laws, we could have universal health care as does every other advanced industrial nation.

The Patient Protection and Affordable Care Act was a step in the right direction. At the time it was signed into law, nearly 50 million Americans were uninsured - many or most because they could not afford it. Single payer or some public-private mix to get truly universal coverage would have clearly been better. But the ACA is perhaps the most we could have hoped for in light of the rabid opposition to the expansion of access to medical insurance.

It's been a hard road so far. Opponents have successfully hampered its implementation (25 Republican-controlled states decided not to expand Medicaid). The startup of the government website was beset with problems. The confusion over health insurance plans that did not meet the new standards was stunning and people were ill informed to deal with the "we're cancelling your insurance" notices sent out by insurance companies.

And it is not going to get any easier. Massive amounts of money are being spent to defeat vulnerable Democrats who supported the ACA in the upcoming 2014 elections. Since September, just one group, the conservative Americans for Prosperity, has spent $20 million on anti-ACA-supporter TV ads. [NY Times, Jan. 15] There are ongoing ad campaigns aimed at convincing younger, healthier Americans not to sign up. Should they be convinced by this onslaught of negativity, premiums will necessarily go up and the rabid opponents of the ACA, who poured millions into these campaigns will say "I told you so."

Here then are some thoughts on the Affordable Care Act at the start of its first fully operational year.

The healthcare.gov rollout was inexcusably botched... The single most important piece of legislation enacted during Obama's first five years relied on a website whose development appears to have been rushed and that lacked adequate pre-startup testing. This one is on Obama and his staff. All IT projects run into problems and, as red state after red state declared their intentions not to set up state health care exchanges, the writing was on the wall. This website would be overwhelmed. Progressives should be angry with Obama for this lack of oversight. The Affordable Care Act is an acid test of the most distinguishing feature between the political philosophies of the two main political parties: Does government have a role in improving the lives of its ordinary citizens? As the title of the History Channel presentation on the NASA space program says "Failure is not an option." The botched rollout was more than what any red blooded Tea Partier or supporter of the corporate oligarchy and the 1% could have hoped for.

...but things are looking up for the healthcare.gov website. After 400 fixes, the downtime was less than 5% by the end of November and it is even better now. "Ping time" (the round-trip delay time for a computer signal) is down to 15- 50 milliseconds. The site can now handle an estimated 800,000 visits per day.

After the fixes, enrollments surged. The LA Times reported on January 13: "More than 2.1 million Americans signed up for health insurance in the last three months of 2013 through new online marketplaces created by President Obama’s health law, as a December surge in enrollment helped the initiative recover from its disastrous launch." Don't forget that one of those last three months was October which saw very few enrollments. So it appears that ACA is enrolling new customers at a rate of about 1 million per month. And there are 3 million more who "have not yet selected a plan but have filled out applications for coverage on the new insurance marketplaces since Oct. 1 and have been deemed eligible for a plan." Finally, in October and November alone approximately 3.9 million people signed up for Medicaid.  If one of the prime purposes of expanding health insurance coverage is to cover those who could not afford it, this surely has to count as a success.

Cancellation of existing policies provided another black eye for the rollout... I don't think the Administration had a clue as to the extent that insurance companies would choose to cancel policies that did not meet Affordable Care Act standards. Rather than enact the necessary provisions (e.g., coverage for prescriptions, hospitalizations and emergency room care), many insurers chose to cancel the policies.  What could have been done to prevent this from bollixing up the works at the eleventh hour as people went to a malfunctioning website after being told they would no longer have health insurance after the end of the year? Several things come to mind: grandfather policies from say January 1, 2013; a notification period of no less than 6 months that your policy was being cancelled; a clear explanation by the President as to what "if you are happy with your existing policy" actually meant (policies in effect as of March 2010 were "grandfathered") ; and, of course, a fully functioning website.

 

...but Obamacare success stories are getting some press.

The Daily Beast, Oct.23 - "The Obamacare Success Stories: From a retired business owner in Arkansas to a young freelance filmmaker in Hollywood, Eleanor Clift highlights a few of the people the media has found who are happy to have Obamacare."

The Daily Kos, Nov. 4 -"Obamacare 'rate shock' victim changes her mind, calls the law a 'blessing in disguise'

TPM,Nov.25 - looks at how "Kentucky Uninsured React To SecuringHealth Care Coverage Under Obamacare"

TheDaily Kos, Dec. 10 -"What Republicans don't want: Florida woman cries tears of joyafter getting $3.19 Obamacare policy"

The Hill, Dec. 29 - "Five states with ObamaCare success"

The most obvious, but surely not the last attempt to defund, repeal or sabotage the Affordable Care Act was the phony debt-ceiling crisis manufactured last year by Republicans. The government was shutdown by the extremists who control the Republican Party. Though it failed miserably, people have a short memory and Republicans' approval ratings are increasing. There's a well-funded campaign in the run-up to the 2014 elections aimed at defeating Democratic legislators who supported the ACA.

There are the advertisements urging young people to opt out. A Yahoo News November 11 headline of an article reporting the shenanigans at the University of Miami read "Anti-Obamacare group entices students with models and a boozy party." What's the reasoning here? As the Yahoo post explains "You see, in order for the health care law to function, lots of healthy, young people must sign up for the exchanges to subsidize older, sicker insurance seekers. So conservative groups are spending a lot of money to convince them not to sign up." Now this logic should outrage any fair-minded person. The absence of a healthier cohort in a health insurance plan raises the rates for everyone. Expect an all-out blitz on this front in the coming months.

Legal challenges may cripple the legislation yet.   It's not over yet in the courts as several legal challenges wend their way towards the Supreme Court.  As reported in the LA Times "The new suits take aim at the parts of the law that offer subsidies to those who are above the poverty level but still may struggle to pay for insurance." 

The most threatening of these lawsuits borders on nit-picking insanity - whether insurance obtained on the Federal health care exchange (as opposed to State exchanges) is eligible for subsidies.  Wording issues such as this one would usually be ironed out between the Administration and Congress.  But in today's hyper-partisan environment, no cooperation can be expected. If this law suit succeeds, then no state without its own exchange would be able to participate in the Federal subsidies. There are 36 states without their own exchanges. Such a ruling would effectively dismantle the Affordable Care Act in these states.

Now for the good news. On January 15, a Federal District Court judge ruled in favor of the Affordable Care Act.  Reuters reports that the judge "upheld subsidies at the heart of President Barack Obama's healthcare overhaul, rejecting one of the main legal challenges to the policy by conservatives opposed to an expansion of the federal government. A ruling in favor of a lawsuit brought by individuals and businesses in Texas, Kansas, Missouri, Tennessee, West Virginia and Virginia would have crippled the implementation of the law by making health insurance unaffordable for many people.  In his ruling, U.S. District Judge Paul Friedman in Washington D.C. wrote that Congress clearly intended to make the subsidies available nationwide under the 2010 Patient Protection and Affordable Care Act. 'There is evidence throughout the statute of Congress's desire to ensure broad access to affordable health coverage,' the judge wrote." 

The respite might be temporary if the plaintiffs take the case to the Supreme Court. But for now, the greatest legal challenge has been overcome.  Stay tuned.  As a great philosopher once said, "It ain't over 'til it's over."

Other Links

Medicaid expansion is going forward in just half of the states.  If every state agreed, more than 20 million Americans could be insured in the next decade.  Here's a link to the Medicaid expansion webpage on the ObamaCare Facts website.  

 

Sunday Round-Up - January 5, 2014

This is the weekly selection of news and opinion from sources outside the US mainstream media.  Today we look at the expiration of long-term unemployment benefits, the Tea Party-controlled states of North Carolina and Florida, the Israeli-Palestinian peace talks, the violence in South Sudan, and Australia's record heat wave.

Thanks to Congressional inaction, long-term unemployment benefits expired the weekend after Christmas.  To see what might happen nationally if this remains the case, take a look at what's happened in North Carolina, which is in the process of becoming one of the most regressive states in the nation. A December 17 piece on the Bloomsberg website by Evan Soltas does just that.  North Carolina Republicans cut long-term unemployment benefits earlier this year. The result: "The state is experiencing the largest labor-force contraction it's ever seen -- 77,000 fewer people were working or searching for work this October than a year ago. This should, but won’t, settle a partisan debate. Cutting unemployment insurance apparently hasn’t encouraged the unemployed to look harder for work: It has caused them to drop out of the labor force altogether."  When there are no jobs to be had, cutting unemployment benefits does nothing but add to the burdens of those on the lower rungs of the economic ladder. 

Mother Jones' Kevin Drum in a December 23 article gives 10 reasons why the long-term unemployment constitutes a national catastrophe.  Besides the widespread human effects, "it turns cyclical unemployment into structural unemployment."  Cutting off long-term unemployment benefits makes the situation worse by causing people to drop out of the job market as they did in North Carolina.  Drum concludes with a faint hope for the restoration of long-term unemployment benefits. "Republicans in Congress have declined to extend unemployment benefits further, and they show no sign of changing their minds when Congress reconvenes in January. Democrats have a plan to fight for further benefits by linking them to a farm bill that Republicans want to pass, and right now that's pretty much the best hope we have to offer the workers who have been most brutally savaged by the Great Recession."

(Image from the Mother Jones article)

 

 

As the country prepares for the 2014 elections, things are looking up (believe it or not) for Republicans.  Some polls show them taking control of the Senate for the last two years of Obama's Presidency.  With the huge number of gerrymandered, safe Republican Congressional districts brought about in red states since the 2010 census and with the voter suppression laws about to take full effect, I expect Democrats to pick up very few, if any, seats in the House without a major Republican meltdown. 

 

So let's imagine what a Tea Party country would look like.  In an article appearing earlier this year, Mother Jones' Stephanie Mencimer asked "What's It Like to Wake Up From a Tea Party Binge? Just Ask Florida!"  She writes: "In just one year, Scott and his conservative allies slashed state spending by $4 billion even as they cut corporate taxes. They've rejected billions in federal funds in one of the states hardest hit by the recession. They've axed everything from health care and public transportation initiatives to mosquito control and water supply programs."  Mencimer provides the following sidebar in her article:

"From high-speed trains to care for terminally ill kids: a few of the federal grants Florida has turned down:
$2.4 billion: High-speed rail

$37.5 million: Support for people moving out of nursing homes

$31.5 million: Home visits for new mothers
$11.1 million: Teen pregnancy and STD prevention
$8.3 million: Three county health centers
$2.1 million: Helping Floridians navigate the health insurance industry
$2 million: Hospice care for children
$2 million: Aid for seniors to pay for Medicare premiums and buy prescription drugs
$1 million: Strengthening state review of insurance premium increases
$1 million: Insurance exchange to help consumers compare plans and buy subsidized coverage
$875,000: Cancer prevention"

Florida, the state with the second highest number of medically uninsured, has been in the lead in the fight against the Affordable Care Act.  The demon has been let out of the proverbial box.  Even though Governor Scott reversed his initial position and supported expansion of Medicaid, the Republicans in the legislature turned him down.  The Kaiser Foundation has estimated that about 4.8 million low-income people in states choosing not to expand Medicaid would have been covered had they lived in another state.  For Florida this number is over 750,000. 

The MJ article was written at a time when Scott was down by high double digits to a generic Democrat in the 2014 election.  Scott made his way back to as close as 4 points during the healthcare.gov rollout debacle and a November Quinnipiac poll has him trailing by just 7 points.  And that's before the big money starts to flow in. 

In Brief - Links to Other Stories of Interest

From The Guardian, Dec. 31
Rightwing Israeli government ministers have stepped up their opposition to a peace deal with the Palestinians before US secretary of state John Kerry's visit to the region this week by backing a parliamentary bill to annex a strategically significant swath of the West Bank.

From The Guardian, Jan. 3
South Sudan's government and rebels finally began talks to end weeks of bloodletting on Friday after days of delay as the United States ordered out more of its embassy staff.  However, there was no face-to-face meeting, and fighting was reported near the key town of Bor, suggesting that a halt to fighting between President Salva Kiir's SPLA government forces and rebels loyal to former vice president Riek Machar is still a long way off. At least 1000 people have died in the fighting that began last month.

From Informed Comment website, Jan. 3
Australia experienced its hottest year on record in 2013, the Bureau of Meteorology said Friday, enduring the longest heat wave ever recorded Down Under as well as destructive bushfires.

From The Guardian, Jan. 4
John Kerry, the US secretary of state, is engaged in intense efforts to coax reluctant Israeli and Palestinian leaders towards an agreement to end their decades-old conflict, against the unhelpful backdrop of mounting political pressure on both sides to reject concessions.